Obama To Announce Ebola Czar

(Tami Hultman) President Obama will announce the appointment of a high-level coordinator to manage the U.S. response to the Ebola outbreak when he visits Atlanta on Tuesday, administration sources have told AllAfrica.

Obama will also discuss U.S. assistance to fight the Ebola virus and will thank the doctors, scientists and health care workers who have been engaged in the effort to stop its escalating spread. A stepped-up administration plan, which has been discussed by officials from across the executive branch for more than a month, received higher level attention this past week as the scope of the outbreak became more widely acknowledged – at least partly in response to pressure from private sector companies engaged in the most-affected countries and from members of Congress [See Ebola ‘Racing Ahead’ of Response]

Companies Organizing, Deploying Aid

ArcelorMittal, a multinational steel manufacturing corporation headquartered in Luxembourg – which has profitable iron ore miningoperations in Liberia – has been hosting telephone conferences for a number of weeks among dozens of global companies, mostly in mining, on an Ebola response. After internal discussions, the companies widened the dialogue to include health officials, such as World Health Organization Director Margaret Chan.

Last Monday, chief executives from 11 of the companies operating in the three most-affected countries of Liberia, Sierra Leone and Guinea,made an urgent appeal for the international community “to pool its resources and lend support” to fight Ebola.

“Our companies have made long term commitments to these countries and their people and we intend to honour these commitments,” the executives said. “Despite the challenging environment, we are continuing where possible with normal operations, with the health and safety of our employees being the absolute priority at all times.”

Riva Levinson, whose boutique Washington DC-based firm KRL International serves both government and corporate clients in west Africa, applauded the private sector efforts as “a valuable tool for mobilization of resources”. She noted that the corporate consultations started before global health organizations and governments, with few exceptions, recognized the urgency of a large-scale response.

Businesses have been sharing information and pooling assets for the Ebola fight in a creative and coordinated way that other sectors should emulate, she said in an interview.

“Companies are inventorying their assets to deploy on the front line to support humanitarian and healthcare workers on a real-time emergency basis,” she said. Their activities include grading roads, providing equipment, including generators, and contributing materials such as chlorine solutions.

“It’s not going to turn the tide,” Levinson said of the corporate effort, “but it’s going to have an impact.”

United States envoys in the three most-affected countries are now points of contact for the broader donor and in-country efforts. There are working groups led by company teams at the operational level in each of the countries, and in Liberia that coordination is managed by a Disaster Assistance Response Team (DART) from USAID.

Senators Call on Administration and Congress to Act

Speaking on the Senate floor on Thursday, Delaware Democrat Chris Coons, who heads the Foreign Relations Africa Subcommittee, called for the appointment of a coordinator, saying it is “critical” for the U.S. government to have “one leadership point”. Coons appealed to the administration and members of Congress “to dramatically increase our support as communities across West Africa struggle to confront and combat Ebola.”

Vermont Democrat Patrick Leahy also addressed the Senate, decrying “the lack of urgency exhibited by much of the international community” and governments, “including our own.” He paid tribute to “courageous public health workers who have risked their lives” and to the Liberian government for its efforts “in the face of woefully inadequate resources.”

Leahy, who chairs the subcommittee that oversees appropriations for the State Department and other international activities and is the Senate’s most senior member, said large budget cuts at the World Health Organization contributed to the slow response, with “ample blame to go around.”

He said Ebola is “a public health issue, a moral issue, and one that should unite us all to do what is necessary to defeat this epidemic.”

On the House side of the U.S. Congress a hearing has been scheduled for Wednesday by the Subcommittee on Africa, Global Health, Global Human Rights, and International Organizations to hear from the National Institutes of Health and other experts.

Waiting for More Government Engagement

The Obama administration raised hopes a week ago for the more robust response that the private sector and front-line treatment organizations – most prominently Médecins Sans Frontières (MSF / Doctors Without Borders) have been advocating. In an NBC Meet the Press interview last Sunday, Obama called Ebola “a national security priority” and pledged that “military assets” would be deployed to assist with efforts to end the epidemic.

The 11 corporate CEOs welcomed “the declaration by President Obama concerning US military support” as “exactly the type of action that is required.”

The private sector and WHO had been calling for logistical and material support for treatment and isolation facilities in the region. They believed that international health workers would be reassured that they could be taken care of if they answered the call to support the hundreds of local clinicians and thousands of local volunteers who have felt abandoned in their efforts.

But the revelation that one of the interventions will be a 25-bed hospital in Monrovia to treat health workers spurred scathing critiques from despairing public health professionals and prompted a Twitter storm of derision. Administration officials countered the angry reactions by insisting that the complex facility is only one element of a larger response.

But even those who publicly praised the U.S. response have said it is still far too little to make the critical difference necessary if the epidemic is to be contained in the west African region.

President-to-President Appeal

Liberian President Ellen Johnson Sirleaf, whose country has been hardest hit by the unprecedented outbreak, partly because of the improved road network leading from the border with Guinea to the Liberian capital Monrovia, made a direct appeal to her American counterpart in a letter dated 9 September.

“Our already limited resources have been stretched to breaking point and up to now only a private charity, Medecins Sans Frontieres (MSF), has responded robustly in all the affected countries,” she wrote. “But they too have reached their limits.”

Johnson Sirleaf pointed out that MSF has over 400 beds of Ebola patients in the region “and not a single staff – medical or support – has ever gotten infected in those centers.” The Liberian president also told President Obama: “Without more direct help from your government, we will lose this battle against Ebola.”

Those working in the three countries – whether businesses or non-governmental organizations – share the conviction that much more must be done by the international community and that there must be a ‘command and control’ authority to coordinate the disparate efforts of both local governments and global partners. Only the United Nations, many believe, is positioned to play that essential role.

On Friday, during a meeting of the National Security Council Principals Committee, the Obama administration’s senior interagency foreign policy decision-making forum, where Ebola was a principal topic for the second time that week, a series of new measures were agreed. Among them, according to officials familiar with the deliberations who are not authorized to speak on the record, was the naming of a senior official to oversee the government’s efforts.

USAID, whose personnel in the affected countries include the DART team in Liberia, has contributed $19.5 million for the Ebola response in west Africa. The ‘continuing resolution’ on the U.S. budget that Congress is expected to pass before adjourning would add another $88 million designated for Ebola efforts. If additional funding the White House has requested for CDC is approved, the U.S. contribution would total about $250 million.

Bipartisan support appears to be growing in Congress for a larger scale supplemental appropriation to urgently address the escalating crisis.

The White House has not released details on an additional role for the Defense Department or the Pentagon’s Africa Command. But on Friday, the American ambassador to Liberia, Deborah Malac, told reporters in Monrovia that Liberian security forces would be receiving training from the U.S. military.

The CDC that Obama will visit Tuesday is on “highest alert level”, Dr. Tom Kenyon, director of the CDC Center for Global Health, told a briefing Friday for representatives of American companies at the Corporate Council on Africa (CCA) in Washington DC. Kenyon, who travelled to the three countries most directly impacted by the disease with CDC head Frieden, said that alert has only occurred four times this decade. CDC has nearly 200 personnel working on Ebola in Atlanta and about 105 in west Africa, he said.

The briefing included presentations by Deputy Secretary of State Bisa Williams, Dr. Marcos Espinal from the World Health Organization and Carol Chan from USAID. The officials stressed the pressing need for additional human and material resources and appealed for private sector assistance, particularly from those with applicable assets on the ground.

Company representatives expressed support but said efforts were hampered by lack of clarity on what is needed and uncertainty about coordination. They requested specifics on what medical supplies, pharmaceuticals and other forms of assistance are needed, and Dr. Espinal said WHO will be issuing a list within the next few days.

“Companies need to know where to go when they want to contribute materials, provide logistics or expertise or get advice for their employees,” said CCA President Stephen Hayes, summing up what he is hearing from his corporate members. “Right now, I don’t think that command-and-control function is in place – or if it is, it is not obvious to the private sector.”